NOTICE OF INTENT TO SUBMIT STATE PLAN AND WAIVER AMENDMENTS AND SOLICITATION OF PUBLIC INPUT Pursuant to 42 C.F.R. § 430.25 Waivers of State plan requirements, 42 C.F.R. § 440.345 EPSDT and other required benefits, 42 C.F.R. § 440.386 Public notice, 42 C.F.R. § 441.304 Duration, extension, and amendment of a waiver, 42 C.F.R. § 447.204 Medicaid provider participation and public process to inform access to care, and 42 C.F.R. § 447.205 Public notice of changes in Statewide methods and standards for setting payment rates, as applicable, the Idaho Department of Health and Welfare Division of Medicaid (Department) provides public notice of its intent to submit State Plan Amendments (SPAs) and a 1915b waiver amendment to the Centers for Medicare and Medicaid Services (CMS). PROPOSED CHANGES Idaho Medicaid intends to submit State Plan Amendments (SPAs) and Waiver Amendments to the Centers for Medicare and Medicaid Services (CMS) to remove and change benefits in the Idaho Medicaid State Plan Basic and Enhanced Alternative Benefit Plans (ABPs), and the 1915(b) managed care waiver including: Discontinue Assertive Community Treatment (ACT) as a unique bundled service. The bundle includes assessment, therapy, assistance with medication management, crisis treatment, co-occurring substance use disorder treatment, skills restoration and care coordination activities through a designated multi-disciplinary team of mental health professionals. Discontinue Mental Health Peer Support for Adults aged twenty-one (21) years and over. Mental health peer support is a program providing support from a Certified Peer Support Specialist (CPSS) using lived experience and special training to assist the participants recovering from mental health concerns. This benefit will continue for participants under the age of twenty-one (21). Discontinue Provider Mileage Reimbursement. Mileage reimbursement is compensation for any mileage accrued attending medical and or mental health appointments. Discontinue Skills Training and Development for Adults Twenty-one Years of Age and Older. Skills Training and Development is a program to enhance personal or family relationships, reduce work or family conflict, and adopt healthy, recovery-oriented behaviors. This benefit will continue for participants under the age of twenty-one (21). Change of Behavior modification services to transition from managed care to Fee-for-Service behavioral intervention under Children’s Habilitation Intervention Services (CHIS). Behavior modification and consultation (BMC) is the design, implementation, and evaluation of social and other environmental modifications to produce meaningful changes in human behavior, competencies, and confidence. On August 22, 2025, the Department issued information release MA25-17 Medicaid Provider Rate Adjustment outlining rate reductions to support Medicaid budget sustainability. This communication included information regarding applicability to managed care programs and optional service suspension to meet the required budgetary holdback. Idaho Medicaid intends to submit a State Plan Amendment (SPA) to Attachment 4.19-A and Attachment 4.19-B pages to update reimbursement language related to the IBHP and the services therein. These changes are in compliance with 42 C.F.R. § 430.25 Waivers of State plan requirements, 42 C.F.R. § 440.345 EPSDT and other required benefits, 42 C.F.R. § 440.386 Public notice, 42 C.F.R. § 441.304 Duration, extension, and amendment of a waiver, 42 C.F.R. § 447.204 Medicaid provider participation and public process to inform access to care, and 42 C.F.R. § 447.205 Public notice of changes in Statewide methods and standards for setting payment rates, as applicable. Proposed Effective Date The Department intends to submit these amendments to CMS with requested effective dates of December 1, 2025. ESTIMATE OF EXPECTED CHANGE IN ANNUAL AGGREGATE EXPENDITURES There is an expected decrease in annual aggregate expenditures under the 1915(b) waiver, due to removing benefits. PUBLIC REVIEW When available, copies of the draft pages will be posted on the IDHW website at https://healthandwelfare.idaho.gov/about-dhw/ policies-procedures-and-waivers (under “Medicaid policies”, PUBLIC-DOCUMENTS > About DHW > Policies & Standards > Medicaid > Draft State Plan Amendments). Unless otherwise specified, copies are also available upon request for public review during regular business hours at any regional Medicaid services office of the Idaho Department of Health and Welfare. Comments and Input Idaho Medicaid appreciates any input or concerns that the public wishes to share regarding these changes. Please submit any comments prior to December 26, 2025, by email addressed to MCPT@dhw.idaho.gov. LOCATIONS FOR PUBLIC REVIEW OF PROPOSED STATE PLAN AMENDMENT Ada County DHW Region 4, 1720 Westgate Drive, Boise, ID 83704 Central District Health Department, 707 North Armstrong Place, Boise, ID 83704 Adams County Adams County Clerk’s Office, 201 Industrial Avenue, Council, ID 83612 Bannock County DHW Region 6, 1070 Hiline, Pocatello, ID 83201 Southeastern Idaho Public Health, 1901 Alvin Ricken Drive, Pocatello, ID 83201 Bear Lake County Southeastern Idaho Public Health, 455 Washington, Suite #2, Montpelier, ID 83254 Benewah County Panhandle Health District, 137 N 8th Street, St Maries, ID 83861 Bingham County DHW Region 6, 701 East Alice, Blackfoot, ID 83221 Southeastern Idaho Public Health, 145 W Idaho Street, Blackfoot, ID 83221 Blaine County South Central Public Health, 117 East Ash Street, Bellevue, ID 83313 Boise County Boise County Clerk’s Office, 420 Main Street, Idaho City, ID 83631 Bonner County DHW Region 1, 207 Larkspur Street, Ponderay, ID 83852 Panhandle Health District, 2101 W. Pine Street, Sandpoint, ID 83864 Bonneville County DHW Region 7, 150 Shoup Avenue, Idaho Falls, ID 83402 Eastern Idaho Public Health, 1250 Hollipark Drive, Idaho Falls, ID 83401 Boundary County Panhandle Health District, 7402 Caribou Street, Bonners Ferry, ID 83805 Butte County Southeastern Idaho Public Health, 178 Sunset Drive, Arco, ID 83213 Camas County Camas County Clerk’s Office, 501 Soldier Road, Fairfield, ID 83327 Canyon County DHW Region 3, 3402 Franklin Road, Caldwell, ID 83605 Southwest District Health, 13307 Miami Lane, Caldwell, ID 83607 Caribou County Southeastern Idaho Public Health, 55 East 1st South, Soda Springs, ID 83276 Cassia County DHW Region 5, 2241 Overland Avenue, Burley, ID 83318 Clark County Eastern Idaho Public Health, 332 West Main, Dubois, ID 83423 Clearwater County North Central Health District, 105 115th Street, Orofino, ID 83544 Custer County Eastern Idaho Public Health, 1050 N. Clinic Road, Suite A, Challis, ID 83226 Elmore County DHW Region 4, 2420 American Legion Blvd., Mountain Home, ID 83647 Central District Health Department, 520 E. 8th Street N, Mountain Home, ID 83647 Franklin County DHW Region 6, 223 North State, Preston, ID 83263 Southeastern Idaho Public Health, 50 West 1 St. South, Preston, ID 83263 Fremont County Eastern Idaho Public Health, 45 South 2nd West, St. Anthony, ID 83445 Gem County Southwest District Health, 1008 East Locust, Emmett, ID 83617 Gooding County South Central Public Health, 255 North Canyon Drive, Gooding, ID 83330 Idaho County DHW Region 2, Camas Resource Center, 216 South C Street, Grangeville, ID 83530 North Central Health District, 903 W Main, Grangeville, ID 83530 Jefferson County Eastern Idaho Public Health, 380 Community Lane, Rigby, ID 83442 Jerome County South Central Public Health, 951 East Avenue H, Jerome, ID 83338 Kootenai County DHW Region 1, 1120 Ironwood Drive, Coeur d’Alene, ID 83814 Panhandle Health District, 8500 N. Atlas Road, Hayden, ID 83835 Latah County DHW Region 2, 1350 Troy Highway, Moscow, ID 83843 North Central Health District, 333 E Palouse River Drive, Moscow, ID 83843 Lemhi County DHW Region 7, 111 Lillian Street, Suite 104, Salmon, ID 83467 Eastern Idaho Public Health, 801 Monroe, Salmon, ID 83467 Lewis County North Central Health District, 132 N Hill Street, Kamiah, ID 83536 Lincoln County South Central Public Health, Lincoln County Community Center, 201 South Beverly St., Shoshone, ID 83352 Madison County DHW Region 7, 333 Walker Drive, Rexburg, ID 83440 Eastern Idaho Public Health, 314 North 3rd East, Rexburg, ID 83440 Minidoka County South Central Public Health, 485 22nd Street, Heyburn, ID 83336 Nez Perce County DHW Region 2, 1118FStreet,Lewiston,ID83501 NorthCentralHealth District, 215 10th Street, Lewiston, ID 83501 Oneida County Southeastern Idaho Public Health, 175 South 300 East, Malad, ID 83252 Owyhee County Southwest District Health, 132 E. Idaho, Homedale, ID 83628 Payette County DHW Region 3, 515 N. 16th Street, Payette, ID 83661 Southwest District Health, 1155 Third Avenue North, Payette, ID 83661 Power County Southeastern Idaho Public Health, 590 1/2 Gifford, American Falls, ID 83211 Shoshone County DHW Region 1, 35 Wildcat Way, Suite B, Kellogg, ID 83837 Panhandle Health District, 114 Riverside Avenue W, Kellogg, ID 83837 Teton County Eastern Idaho Public Health, 820 Valley Centre Drive, Driggs, ID 83422 Twin Falls County DHW Region 5, 601 Pole Line Road, Twin Falls, ID 83301 South Central Public Health, 1020 Washington Street North, Twin Falls, ID 83301 Valley County Central District Health Department, 703 1st Street, McCall, ID 83638 Washington County Southwest District Health, 46 West Court, Weiser, ID 83672 PUBLIC COMMENT The Department is accepting written and recorded comments regarding the proposed changes for a period of at least thirty (30) calendar days. Any persons wishing to provide input may submit comments. Comments must be received by the Department within thirty (30) days of the posting of this notice, and must be sent using one of the following methods: · Send Email Comments To: MCPT@dhw.idaho.gov · Call and Leave Recorded Comments At: (208) 364-1887 · Send Fax Comments To: (208) 287-1170 · Mail Comments To: Division of Medicaid · PO Box 83720, Boise, ID 83720-0009 · Attn: Policy Team Hand Deliver Comments During Regular Business Hours (M-F from 8AM to 5PM, except holidays) To: Division of Medicaid 450 West State Street, 6th Floor, Boise, ID 83720 Attn: Policy Team The Department will review all comments received prior to submitting the changes to CMS. PUBLIC HEARING No public hearings have been scheduled at this time. QUESTIONS For technical questions or to review the changes, e-mail the request to MCPT@dhw.idaho.gov.